Meredith O'Connor

Developmental antecedents of abnormal eating attitudes and behaviors in adolescence

OBJECTIVE This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences. METHOD Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point. RESULTS Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys. DISCUSSION Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention.

Understanding the impact of special health care needs on early school functioning: a conceptual model

Children with special health care needs (SHCN) have or are at increased risk for a chronic condition that necessitates more health and related supports than their peers. While it is generally accepted that these children are at risk for school failure, the mechanisms through which SHCN impact on childrens experiences (and therefore opportunities to intervene) at school are still relatively poorly understood. Based on the current literature, this paper provides a conceptual framework to guide further discussion of this issue in research, policy and practice. Evidence from the literature was reviewed and existing frameworks examined. We propose that SHCN impact on four interrelated domains of childrens functioning: (1) body functions and structures; (2) activities of daily living; (3) social participation; and (4) educational participation. Childrens functioning is further influenced by risk and protective factors that can be identified at the level of the child, family and service systems. Together, these processes contribute to shaping either positive or negative trajectories of school functioning. The mechanisms influencing school experiences for children with special health care needs are complex, with opportunities for positive interventions at a range of levels. The proposed conceptual model provides an accessible tool for guiding discussion of the support needs of this vulnerable population.

Early development of emerging and English-proficient bilingual children at school entry in an Australian population cohort

Children who enter school with limited proficiency in the language of instruction face a range of challenges in negotiating this new context, yet limited data have been available to describe the early developmental outcomes of this subpopulation in the Australian context. The Australian Early Development Index (AEDI) is a teacher-rated checklist that measures five important domains of child development: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, and communication skills and general knowledge. In 2009, the AEDI was completed for 97.5% of Australian children in their first year of schooling (N = 261,147; M = 5 years, 7 months of age), providing a unique opportunity to explore the cross-sectional associations between language background, proficiency in English, and early developmental outcomes at the population-level. Logistic regression analyses revealed that, compared to their peers from English-speaking backgrounds, bilingual children who were not yet proficient in English had substantially higher odds of being in the “vulnerable” range (bottom 10th percentile) on the AEDI domains (OR = 2.88, p < .001, to OR = 7.49, p < .001), whereas English-proficient bilingual children had equal or slightly lower odds (OR = .84, p < .001, to OR = .97, ns). Future research with longitudinal data is now needed to establish causal pathways and explore long term outcomes.

Differentiating three conceptualisations of the relationship between positive development and psychopathology during the transition to adulthood

The transition to adulthood is characterised by both great potential for positive change and a relatively high incidence of problem outcomes. A multidimensional model of positive development during the transition to adulthood (at 19-20 years) has recently been proposed. However, an unresolved question regarding the nature of positive development during this time is how best to conceptualise its relationship to psychopathology. We drew on data from 1158 participants in the Australian Temperament Project, a large longitudinal community-based study that has followed young peoples psychosocial adjustment from infancy to early adulthood. Using structural equation modelling, we compared three models reflecting different conceptualisations of the relationship between positive development and psychopathology. The results suggest that positive development and psychopathology are best modelled as separate but correlated constructs. Hence, development in one domain is likely to influence the other, although separate and specific developmental pathways are also likely to be operating.

The longitudinal prediction of alcohol consumption-related harms among young adults

This study explores the longitudinal pathways by which risk and protective factors influence the development of alcohol-related harms in a representative community sample of 941 young adults (19–20 years) from Victoria, Australia, focusing on the role of concurrent risky drinking. Impulsivity at 15–16 years, alcohol-related harms at 15–16 years and 17–18 years, frequency of intoxication at 17–18 years, and antisocial behavior, friends’ drinking and living arrangements at 19–20 years were directly related to alcohol-related harms, as well as indirectly related to harms through increased risky drinking. Paternal drinking at 17–18 years was directly related to alcohol-related harms. Friends’ drinking at 19–20 years and alcohol-related harms at age 17–18 interacted with risky drinking to increase the likelihood of alcohol-related harms. Implications for intervention efforts are discussed.

The relationship between positive development and psychopathology during the transition to adulthood: A person-centred approach

The transition to adulthood is characterised by potential for both positive development and problem outcomes such as psychopathology, yet little is known about relationships between the two. Given the diversity of pathways observed during this transition period, there is likely to be significant heterogeneity in young peoples experiences of these outcomes. Drawing on data from 1158 19-20 year olds in the Australian Temperament Project and using latent profile analysis, we identified six subgroups. For most, higher positive development was associated with lower psychopathology and vice versa. One group (33.6%) was high across all positive development measures and low on psychopathology, and another (47.7%) average in both areas. The remaining four groups were low on positive development but differentiated by average psychopathology (4.7%), high internalising (5.5%), and moderate (7.2%) and severe (1.3%) externalising problems. Tailored intervention strategies that address both the promotion of competence and prevention of problem outcomes are needed.

Can the neighborhood built environment make a difference in children's development? Building the research agenda to create evidence for place-based children's policy

Healthy child development is determined by a combination of physical, social, family, individual, and environmental factors. Thus far, the majority of child development research has focused on the influence of individual, family, and school environments and has largely ignored the neighborhood context despite the increasing policy interest. Yet given that neighborhoods are the locations where children spend large periods of time outside of home and school, it is plausible the physical design of neighborhoods (built environment), including access to local amenities, can affect child development. The relatively few studies exploring this relationship support associations between child development and neighborhood destinations, green spaces, interaction with nature, traffic exposure, and housing density. These studies emphasize the need to more deeply understand how child development outcomes might be influenced by the neighborhood built environment. Pursuing this research space is well aligned with the current global movements on livable and child-friendly cities. It has direct public policy impact by informing planning policies across a range of sectors (urban design and planning, transport, public health, and pediatrics) to implement place-based interventions and initiatives that target childrens health and development at the community level. We argue for the importance of exploring the effect of the neighborhood built environment on child development as a crucial first step toward informing urban design principles to help reduce developmental vulnerability in children and to set optimal child development trajectories early.

Predictors of mental health competence in a population cohort of Australian children

Background The child mental health epidemiology literature focuses almost exclusively on reporting the prevalence and predictors of child mental disorders. However, there is growing recognition of positive mental health or mental health competence as an independent outcome that cannot be inferred from the absence of problems, and requires epidemiological investigation in its own right. Methods We developed a novel measure of child mental health competence within the framework of the Australian Early Development Index, a three-yearly national census of early child development. Predictors of this outcome were investigated by linking these census data at individual level to detailed background information collected by a large longitudinal cohort study. Results Predictors of competence were consistent with previously described theoretical and empirical models. Overall, boys were significantly less likely than girls to demonstrate a high level of competence (OR 0.60, 95% CI 0.39 to 0.91). Other strong predictors of competence were parent education and a relative absence of maternal psychological distress; these factors also appeared to attenuate the negative effect of family hardship on child competence. Conclusions This measure of mental health competence shows promise as a population-level indicator with the potential benefit of informing and evaluating evidence-based public health intervention strategies that promote positive mental health.

The English proficiency and academic language skills of Australian bilingual children during the primary school years.

Purpose: Evidence suggests that early proficiency in the language of school instruction is an important predictor of academic success for bilingual children. This study investigated whether English-proficiency at 4–5 years of age predicts academic language and literacy skills among Australian bilingual children at 10–11 years of age, as part of the Longitudinal Study of Australian Children (LSAC, 2012). Method: The LSAC comprises a nationally representative clustered cross-sequential sample of Australian children. Data were analysed from a sub-sample of 129 bilingual children from the LSAC Kindergarten cohort (n = 4983), for whom teachers completed the Australian Early Development Index (AEDI) checklist (a population measure of early childhood development) and the Academic Rating Scale (ARS) language and literacy subscale. Result: Linear regression analyses revealed that bilingual children who commenced school with stronger English proficiency had higher academic language and literacy scores at the end of primary school (β = 0.45). English proficiency remained a significant predictor, even when accounting for gender and socio-economic disadvantage (β = 0.38). Conclusion: The findings indicate that bilingual children who begin school without English proficiency are at risk of difficulties with academic language and literacy, even after 6 years of schooling. Risk factors need to be identified so early support can be targeted towards the most vulnerable children.

Epidemiology of positive mental health in a national census of children at school entry

Background Until now, child mental health promotion efforts have focused primarily on reducing the prevalence and severity of problems; yet the absence of mental health problems does not necessarily imply the presence of healthy psychosocial functioning. We aimed to investigate the epidemiology of child mental health competence in a full national population of school entrants. Methods The data source was the 2012 Australian Early Development Index, a national census of early childhood development completed for school entrants by teachers across Australia (n=275 800). The mental health competence outcome measure was derived from constructs that focused on childrens social and emotional strengths. Children with mental health competence scores in the top quintile were compared with the standard population across individual and community characteristics. Results Average age at assessment was 5 years 7 months. Higher odds of mental health competence were observed for children who lived in more advantaged areas (OR 1.62; 99% CI 1.49 to 1.75), had attended preschool (1.38; 1.25 to 1.51) and demonstrated effective oral communication skills in the classroom (19.01; 15.62 to 23.13). Indigenous children had lower odds compared with non-Indigenous children (0.59; 0.54 to 0.64). Children in disadvantaged areas who attended preschool did not ‘catch up’ with their more advantaged peers. Conclusions Mental health competence is unequally distributed across the Australian child population at school entry and is strongly predicted by measures and correlates of disadvantage. Effective oral communication and attendance at preschool warrant further investigation as potentially modifiable factors that may support mental health competence in new school entrants.